Individual
KAELYN MAXINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
306 MONTEREY DR, CARSON, CA 90745-6446
(323) 872-2522
Mailing address
306 MONTEREY DR, CARSON, CA 90745-6446
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86104310
CA
Other
Enumeration date
03/25/2020
Last updated
03/28/2020
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